Contemporary indications for the Caldwell-Luc procedure

The Caldwell-Luc operation was first described in the late 19th century as a technique to remove infection and diseased mucosa from the maxillary sinus via the canine fossa, while creating intranasal counterdrainage through the inferior meatus. This operation has been performed countless times over the past century, but it has come under increased scrutiny within the past 20 years. This criticism is multifactorial. Medical management of allergic and infectious sinus disease has continued to improve, and endoscopic sinus surgery techniques have proven to be safe and effective in the vast majority of patients requiring surgical management. Additionally, several retrospective studies have shown high complication rates with the operation. Recent studies have illustrated both the histologic benefit of complete removal of diseased mucosa, as well as better patient outcomes with minimal morbidity when a safer operative technique is used. Overall, the Caldwell-Luc procedure is safe and effective as described, and should remain in the repertoire of surgeons managing the maxillary sinus.